Intramyocardial Injection of Autologous Platelet-Rich Plasma Combined with Transmyocardial Revascularization
| Autor: | K. E. Wehberg M.D., G. Answini, D. Wood, J. Todd, J. Julian, N. Ogburn, K. B. Allen |
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| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: | |
| Zdroj: | Cell Transplantation, Vol 18 (2009) |
| Druh dokumentu: | article |
| ISSN: | 0963-6897 1555-3892 |
| DOI: | 10.3727/096368909788534988 |
| Popis: | Transmyocardial revascularization (TMR) can improve refractory angina but does not consistently demonstrate an effect on myocardial function. Recent studies suggest a synergistic effect between TMR and exogenously supplied growth factors. We evaluated the clinical role of intramyocardial injection of autologous platelet-rich plasma (PRP) in conjunction with TMR. Twenty-five nonrevascularizable patients with class III/IV angina underwent minimally invasive sole therapy TMR during a 5-year period at a single institution. Group 1 (14 patients) underwent TMR alone while group 2 (11 patients) underwent TMR plus injection of PRP (Magellan plasma separator) between TMR channels. Blinded angina assessment and ejection fraction (EF) were measured preoperatively and at 6 months postoperatively. Baseline EF (57 ± 10% vs. 50 ± 7%), angina class (3.7 ± 0.5 vs. 3.7 ± 0.5), and the number of channels (48 ± 5 vs. 48 ± 4) were statistically similar in both groups. At 6 months, two class angina relief was similar in both groups (92% vs. 100%, p = 0.4); however, the TMR + PRP group had a lower average angina score (1.3 vs. 0.4, p = 0.07) and more were angina free (23% vs. 78%, p = 0.04) than the TMR-alone group. EF improved in the TMR + PRP group (–2.0% vs. +9.0%, p = 0.07) compared to the TMR-alone group. Two 30-day morbidities occurred in the TMR-alone group (atrial fibrillation and left pleural effusion) and one mortality occurred in the TMR + PRP group. Intramyocardial injection of autologous PRP combined with TMR may be more efficacious at relieving angina and improving myocardial function than TMR alone. |
| Databáze: | Directory of Open Access Journals |
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